Concentrated Growth Factor enhances Epithelialization after Mastoid Obliteration in Endoscopic Transcanal Canal Wall Down Mastoidectomy

Abstract

Background: Chronic otitis media with cholesteatoma often requires canal wall down mastoidectomy, even though effective in disease clearance, results in an open mastoid cavity prone to delayed epithelialization and persistent discharge. Mastoid obliteration has been employed to reduce cavity-related complications; however, optimal healing remains a challenge. Concentrated growth factors, an autologous platelet concentrate rich in growth factors, have shown potential in enhancing tissue regeneration and wound healing.

Objective: To evaluate the efficacy of Concentrated Growth Factor (CGF) combined with Hydroxyapatite (HA) versus HA alone in mastoid cavity obliteration following Canal Wall Down (CWD) mastoidectomy, specifically focusing on the rate and quality of epithelialization.

Methods: A total of 60 patients undergoing primary CWD mastoidectomy were enrolled and divided into two groups: those receiving HA alone (n=31) and those receiving a combination of HA and CGF (n=29). Postoperative healing was assessed using otoendoscopy.

Results: The postoperative complications, such as ear discharge, graft swelling, and signs of poor vascularisation, were more frequent in the HA group than the CGF/HA group. A significantly higher proportion of patients in the CGF/HA group achieved complete epithelialization within 60 days.

Conclusion: The addition of CGF into mastoid cavity obliteration significantly accelerates epithelialization and shortens the recovery period following CWD mastoidectomy. These findings suggest that CGF is a highly effective biological adjunct in otologic surgery.

Keywords: Cholesteatoma, Concentrated growth factor, Canal wall down mastoidectomy, Mastoid obliteration